1Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

2Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

3Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin, Taiwan

Correspondence to Dr Hsiu-Po Wang, Department of Internal Medicine, Division of Gastroenterology, National Taiwan University Hospital and National Taiwan University, College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan; wanghp{at}ntu.edu.tw

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Clinical presentation

Our patient, a 55-year-old man, was a heavy drinker: 30 g every day for more than 10 years. Epigastralgia with transmission to the back developed 1 month before admission. The pain was dull, combined with diaphoresis, aggravated by alcohol intake, and released by lying posture. Because of the progressive discomfort, he visited a local hospital where acute pancreatitis was diagnosed by elevated serum amylase (157 U/l) and lipase (397 U/l). In addition, a pancreatic tumour was also found …

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